Psychometrics of the Functional Oral Intake Scale for Infants

Abstract

This study aimed to investigate the reliability and validity of the Functional Oral Intake Scale (FOIS) for infants. Infants (age, <1 year) who underwent a videofluoroscopic swallowing study (VFSS) were included in this retrospective study. Their nutrition records at the time of the VFSS were separately evaluated by two raters using the five-point FOIS for infants. Categorical swallowing and aspiration impairment scale data were also obtained from the VFSS. The inter-rater reliability of the FOIS for infants was high (95.5% absolute agreement) among the 201 evaluated infants, and this scale was significantly correlated with aspiration severity in the VFSS. We also investigated whether infants with partial oral feeding (POF) at the FOIS evaluation had achieved full oral feeding within 1 year of the evaluation and used this information to estimate whether the caloric contribution, as well as consistency of oral feeding, affected the feeding outcomes. This analysis included 33 infants who were receiving both oral and tube feeding (i.e., POF). Among them, 26 infants achieved full oral feeding (FOF) without tube feeding after 1 year. Their initial contribution from oral feeding was higher than that in infants who still maintained POF after 1 year (28.46 ± 22.79 vs. 6.00 ± 5.45%, p < 0.001). The five-point FOIS for infants, which reflected the expansion of their oral diet with growth, had adequate reliability and validity. The caloric contribution as well as consistency of oral feeding could be used to distinguish FOIS levels 2 and 3, which correspond to the POF status in infants.

Evolution of bulbar function in spinal muscular atrophy type 1 treated with nusinersen

“…We used the 6‐point graded p‐FOIS which had excellent interrater reliability and validity, similar to previous studies in adults and paediatric cohorts and enabling tracking of functional abilities using a single measure across all time points. 14 , 19 , 20 Of note, we evaluated the p‐FOIS in children aged 0 to 16 years in the validation process, reflecting the full age range of SMA assessed in most paediatric settings.…”

Consensus on level descriptors for a functional children's eating and drinking activity scale

“…Numerous efforts to adapt the FOIS 13 for use with children have been made, but none were suited to assessing outcomes in a population with paediatric feeding disorders irrespective of the child's age, underlying aetiology, or care setting. [16][17][18][19][20] This study used systematic compilation of expert opinions to develop collective agreement on level descriptor wording for a 6-point ordinal scale measuring functional oral intake in children. To reduce confusion, given the number of previously reported paediatric FOIS versions, the study team proposes calling this scale the Children's Eating and Drinking Activity Scale (CEDAS).…”

Postextubation dysphagia in critically ill children: A prospective cohort study

“…Second, there is no validated tool for assessing dysphagia in children. Still, the FOIS for adults has been modified and is widely used for infants 9,31 based on recommendations of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition 30 . Additionally, clinical practice has shown that the FOIS is appropriate for younger children 12 .…”